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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

26卷

期数:

2020年06期

页码:

553-556

栏目:

临床医学

出版日期:

2020-11-20

文章信息/Info

Title:

Clinical analysis of colorectal cancer with urinary system diseases

作者:

李鹏昊¹; 郝敬鹏¹; 王晖¹; 张洪团²; 张昌文²; 张志宏²

1.天津医科大学第二医院肛肠外科，天津300211；2.天津医科大学第二医院泌尿外科，天津300211

Author(s):

LI Peng-hao¹; HAO Jing-peng¹; WANG Hui¹; ZHANG Hong-tuan²; ZHANG Chang-wen²; ZHANG Zhi-hong²

1.Department of Anorectal Surgery，The Second Hospital of Tianjin Medical University，Tianjin 300211，China；2.Department of Urology，The Second Hospital of Tianjin Medical University，Tianjin 300211，China

关键词:

多原发癌; 结直肠肿瘤; 泌尿系统肿瘤; 结直肠外科手术

Keywords:

multiple primary carcinoma; colorectal cancer; urinary system tumor; colorectal surgery

分类号:

R735.34+R737.1+R737.2

DOI:

-

文献标志码:

A

摘要:

目的：探讨结直肠癌累及泌尿系统或合并泌尿系统多原发癌的临床特点、诊断和治疗方法。方法：对2010-2019年我院收治的75例结直肠癌累及泌尿系统或合并泌尿系统多原发癌患者的临床病理资料进行回顾性分析。结果：16例结直肠癌累及一个或多个泌尿系统器官，其中16例全部累及膀胱，同时累及输尿管1例；59例同时或异时性合并泌尿系肿瘤，其中33例单纯合并膀胱癌，17例单纯合并前列腺癌，3例单纯合并输尿管癌，1例单纯合并肾盂癌，1例合并膀胱癌及肾癌，1例合并输尿管癌及前列腺癌，3例合并膀胱癌及输尿管癌。Dukes分期 （以病理分期最晚的一个为准）：A期0例，B期46例，C期21例，D期8例。75例中伴有淋巴结转移者29例。结直肠癌累及膀胱的16例中，结直肠癌根治联合膀胱部分切除14例，其余2例因肿瘤累及膀胱三角区行全膀胱切除及尿流改道。结直肠癌累及膀胱及输尿管的1例行膀胱部分切除、受累输尿管切除、输尿管吻合术。同时性多重癌7例，异时性多重癌52例，与原发癌间隔时间半年至 19年，其中小于2年者 15 例，2～5年者 7例，大于5年者 30 例。54例异时性多原发癌的初发癌均行根治性手术，14例二重癌和2例三重癌均行根治性切除术。同时性多原发结直肠癌和异时性多原发癌初发癌根治术后5年生存率分别为65％和70％。结论：结直肠癌合并泌尿系统疾病的患者，应利用膀胱镜、电子结肠镜及腹部强化CT进行仔细检查，避免漏诊或误诊，行根治性手术切除结直肠及泌尿系统肿瘤可能使患者生存获益。

Abstract:

Objective: To investigate the clinical features，diagnosis and treatment of colorectal cancer involving the urinary system or complicated with multiple primary cancers of the urinary system. Methods: Retrospective analysis was made on the clinicopathological data of 75 colorectal cancer patients with urinary tract involvement or multiple primary cancers of the urinary system admitted to our hospital from 2010 to 2019. Results: There were 16 cases of colorectal cancer involving one or more urinary organs，including 16 cases involving the bladder and 1 case involving the ureter. There were 59 cases of synchronous or heterochronous urinary tumors，including 33 cases with bladder cancer，17 cases with prostate cancer，3 cases with ureteral cancer，1 case with renal pelvis cancer，1 case with ureteral cancer，1 case with ureteral cancer and prostate cancer，and 3 cases with ureteral cancer and ureteral cancer. Dukes stage （according to the latest pathological stage）: 0 cases of stage A，46 cases of stage B，21 cases of stage C，8 cases of stage D. Among the 75 patients，29 had lymph node metastasis. Among the 16 cases of colorectal cancer involving bladder，radical resection combined with partial cystectomy was performed in 14 cases，and total cystectomy and urinary diversion were performed in the other 2 cases due to tumor involving trigone of bladder. Partial cystectomy，ureterectomy and ureteral anastomosis were performed in 1 case of colorectal cancer involving bladder and ureter. There were 7 cases of concurrent multiple cancers and 52 cases of heterogeneous multiple cancers，and the interval from the primary cancer was 6 months to 19 years，among which 15 cases were less than 2 years，7 cases were 2 to 5 years，and 30 cases were more than 5 years. All the 54 cases of primary heterogeneous multiple primary carcinoma underwent radical surgery，and all the 14 cases of double and 2 cases of triple carcinoma underwent radical resection. The 5 year survival rates were 65% and 70% after radical resection for synchronous multiple primary colorectal cancer and heterosynchronous multiple primary cancer，respectively. Conclusion: For patients with colorectal cancer combined with urinary system diseases，cystoscopy，electronic colonoscopy and abdominal enhanced CT should be used for careful examination to avoid missed diagnosis or misdiagnosis. Radical surgical resection of colorectal and urinary system tumors may benefit the survival of patients.

参考文献/References:

[1] Lv M，Zhang X，Shen Y，et al. Clinical analysis and prognosis of synchronous and metachronous multiple primary malignant tumors[J]. Medicine（Baltimore），2017，96（17）：e6799
[2] Kondo A，Sasaki T，Kitaguchi D，et al. Resection of the urinary bladder for locally advanced colorectal cancer： a retrospective comparison of partial versus total cystectomy[J]. BMC Surg，2019， 19（1）：63
[3] Takiyama A，Nozawa H，Ishihara S，et al. Secondary metastasis in the lymph node of the bowel invaded by colon cancer： a report of three cases[J]. World J Surg Oncol，2016，14（1）：273
[4] Tawfik Amin A，Salem A A S，Ibrahim A. Surgery for locally advanced GIT cancers has potentially good postoperative outcomes in a tertiary hospital[J]. J Gastrointest Cancer.2020，51（1）：23
[5] Kim D D，Litow K J，Lumbra T J，et al. Failure of 3 different methods and biopsy sites to diagnose a patient with invasive colorectal cancer： a case report[J]. Medicine（Baltimore），2019，98 （19）：e15656
[6] Turner G A，Harris C A，Eglinton T W，et al. Cystoprostatectomy versus prostatectomy alone for locally advanced or recurrent pelvic cancer[J]. ANZ J Surg，2016，86（1/2）：54
[7] Kondo A，Sasaki T，Kitaguchi D，et al. Resection of the urinary bladder for locally advanced colorectal cancer：a retrospective comparison of partial versus total cystectomy[J]. BMC Surg，2019，19 （1）：63
[8] Yang T X，Morris D L，Chua T C. Pelvic exenteration for rectal cancer： a systematic review[J]. Dis Colon Rectum，2013，56（4）：519
[9] Kitano S，Inomata M，Mizusawa J，et al. Survival outcomes following laparoscopic versus open D3 dissection for stage Ⅱor Ⅲcolon cancer（JCOG0404）：a phase 3，randomised controlled trial[J]. Lancet Gastroenterol Hepatol，2017，2（4）：261
[10] 耿振英，焦顺昌，王甦，等. 106例多原发癌的临床回顾性研究[J]. 世界最新医学信息文摘，2017，17（12）： 1
[11] Li F，Zhong W Z，Niu F Y，et al. Multiple primary malignancies involving lung cancer[J]. BMC Cancer，2015，15：696
[12] Lv M，Zhang X，Shen Y，et al. Clinical analysis and prognosis of synchronous and metachronous multiple primary malignant tumors[J]. Medicine （Baltimore），2017，96（17）：e6799
[13] Li F，Zhong W Z，Niu F Y，et al. Multiple primary malignancies involving lung cancer[J]. BMC Cancer，2015，15：696
[14] Corso G，Veronesi P，Santomauro G I，et al. Multiple primary non-breast tumors in breast cancer survivors[J]. J Cancer Res Clin Oncol，2018，144（5）：979
[15] Boddu P C，Zeidan A M. Myeloid disorders after autoimmune disease[J]. Best Pract Res Clin Haematol ，2019，32（1）：74
[16] Beebe-Dimmer J L，Yee C，Paskett E，et al. Family history of prostate and colorectal cancer and risk of colorectal cancer in the women′s health initiative[J]. BMC Cancer，2017，17（1）：848
[17] Shoji F，Yamazaki K，Miura N，et al. Postoperative management of multiple primary cancers associated with non-small cell lung cancer[J]. Anticancer Res，2018，38（6）：3773

相似文献/References:

[1]许丹丹,王茹瑶,刘 蕊,等.老年结直肠癌的危险因素及与循环IGF-1水平的相关性研究[J].天津医科大学学报,2016,22(05):424.
　XU Dan-dan,WANG Ru-yao,LIU Rui,et al.Research on the risk factors of senile colorectal cancer and the correlation with circulating insulin-like growth factor-1[J].Journal of Tianjin Medical University,2016,22(06):424.

备注/Memo

备注/Memo:

文章编号 1006-8147（2020）06-0553-04
作者简介 李鹏昊(1988 -)，男，医师，硕士，研究方向：结直肠外科；E-mail:lzmlph@163.com。

常用功能

更新日期/Last Update: 2020-11-20